Among 461,706 Florida middle and high school students surveyed from 2010-2020, blunt use declined through 2015 then reversed, with notable increases among girls, middle schoolers, and white students from 2015-2020.
School health officials, tobacco prevention program designers, youth substance use researchers
14.91% annual increase in current blunt use from 2015 to 2018
What the researchers found
Past and current blunt use declined from 2010 to 2015 (APC = -5.32% and -5.28%), but current use increased from 2015 to 2018 (APC = 14.91%) before leveling off. Rising trends were especially pronounced among female students (APC = 14.92%), middle schoolers (APC = 19.57%), and non-Hispanic white students (APC = 11.12%) from 2016 to 2020. Use of cigarettes, e-cigarettes, hookah, cigars, and vaping marijuana were all associated with blunt use.
Why it matters
Blunts combine tobacco (from the cigar wrapper) with marijuana, exposing users to both substances. The reversal in declining trends and spread to new demographic groups suggests that existing tobacco prevention programs have not adequately addressed blunt use.
The numbers in context
461,706 students; past use APC -5.32% (2010-2015); current use APC -5.28% (2010-2015) then +14.91% (2015-2018); female APC +14.92% (2016-2020); middle school APC +19.57% (2016-2020); NH white APC +11.12% (2016-2020)
How the study worked
Analysis of 2010-2020 cross-sectional, statewide representative Florida Youth Tobacco Surveys comprising 461,706 middle and high school students. Joinpoint regression calculated annual percentage change in blunt use prevalence. Multivariable regression using 2019-2020 data examined associated factors.
What this study cannot tell us
Florida data may not generalize to other states. Self-reported data in school settings may underestimate use. Cross-sectional surveys cannot track individual trajectories. Blunt definition may vary among respondents.
How to read the evidence
Large statewide representative survey with sophisticated trend analysis, though limited to one state and self-reported data.
When this study was published
Published in 2021 covering 2010-2020 survey data.
The bigger picture
The demographic shift in blunt use, with increases among girls, younger students, and white youth, suggests the behavior is diffusing beyond its historical concentration among older male and Black students, requiring broader prevention messaging.
Questions still open
- What drove the reversal in blunt use trends after 2015? Is the increase among middle schoolers reflecting earlier initiation or just increased reporting? Should blunt-specific modules be integrated into existing tobacco prevention programs?
Common questions
What is a blunt?
Why did blunt use increase after 2015?
Read the original research
Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020.
Pediatrics, 148(1)
Citation
Ebrahimi Kalan, Mohammad; Jebai, Rime; Bursac, Zoran; Popova, Lucy; Gautam, Prem; Li, Wei; Alqahtani, Mohammed M; Taskin, Tanjila; Atwell, Leah L; Richards, Jennifer; Ward, Kenneth D; Behaleh, Raed; Ben Taleb, Ziyad. (2021). Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020.. Pediatrics, 148(1). https://doi.org/10.1542/peds.2020-028159
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